An Investigation On Dispositive in The Mental Health Field in Turkey
Author: Balkir Uysal, balkiruysal@gmail.com
Department: Sociology
University: Mimar Sinan Fine Arts University, Turkey
Supervisor: Yildirim Sentürk
Year of completion: 2024
Language of dissertation: Turkish
Keywords:
Mental Health
, Dispositive
, Governmentality
, Community-based Services
Areas of Research:
Mental Health and Illness
, Social Transformations
, Poverty, Social Welfare and Social Policy
Abstract
In this study, the establishment and functioning of the mental health field in Turkey were examined at the legal, spatial, scientific, institutional, and discursive levels through dispositives in the meaning used by Michel Foucault. In particular, the reflections in Turkey on and/or of the problematics that emerged during the period called deinstitutionalization, which aimed at community-based care and developed based on criticism of institutional psychiatry, were discussed. First, the course of mental health reforms, which started with the myth of breaking the chains of insane people locked up in asylums in Europe at the end of the eighteenth century, has been traced to deinstitutionalization following the period when madness was medicalized, and the foundations of institutional psychiatry were laid. Subsequently, the neoliberal policies that have increased in intensity and impact since the 1980s, in contrast with the rise of the approaches called community-based services in the 1970s, were analyzed—neoliberal policies which emphasize benefit-cost analysis, reduce public services, and shape mental health with a governmentalism that transfers the responsibility of the state more to individuals. Based on developments in the world and transformations in general health policies, how the field of mental health was established in Turkey, and which routes it followed, is exhibited, mainly focusing on the transformation in the field of mental health, which was expressed as the transition to a community-based model in 2006. By excavating the transformation discourse, this study aims to decipher the mechanisms that operate a specific power in the field and the positions and forms of each component it covers. In Turkey, with the transition to community-based services, institutionalization has been reduced, but practices for individuals with mental problems continue to be based on paternalism that focuses on home care services and assigns a central role to the family in undertaking care work. Community-based mental health services have also been evaluated critically. Under the siege of neoliberalism, the transformations in the field of mental health and the effects of social policy and social work practices that focus on home care and put the family at the center have been discussed with a certain integrity. In this context, based on in-depth interviews with individuals, family members, and professional staff, issues such as what the maneuvers in the field of mental health consist of and how the mechanisms of inclusion and exclusion operate in the social sphere were examined. Although the research focuses on the mental health field, it aims to make the discussion suitable for examination in terms of other fields, such as control, institution, care, family, ethics, and values, beyond a study limited to the history of psychiatry or sociology of health.
